Sally S. Dickerson

Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research.

This meta-analysis reviews 208 laboratory studies of acute psychological stressors and tests a theoretical model delineating conditions capable of eliciting cortisol responses. Psychological stressors increased cortisol levels; however, effects varied widely across tasks. Consistent with the theoretical model, motivated performance tasks elicited cortisol responses if they were uncontrollable or characterized by social-evaluative threat (task performance could be negatively judged by others), when methodological factors and other stressor characteristics were controlled for. Tasks containing both uncontrollable and social-evaluative elements were associated with the largest cortisol and adrenocorticotropin hormone changes and the longest times to recovery. These findings are consistent with the animal literature on the physiological effects of uncontrollable social threat and contradict the belief that cortisol is responsive to all types of stressors.

Who talks? The social psychology of illness support groups.

More Americans try to change their health behaviors through self-help than through all other forms of professionally designed programs. Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health, yet little is known about patterns of support group participation in health care. What kinds of illness experiences prompt patients to seek each others company? In an effort to observe social comparison processes with real-world relevance, support group participation was measured for 20 disease categories in 4 metropolitan areas (New York, Chicago, Los Angeles, and Dallas) and on 2 on-line forums. Support seeking was highest for diseases viewed as stigmatizing (e.g., AIDS, alcoholism, breast and prostate cancer) and was lowest for less embarrassing but equally devastating disorders, such as heart disease. The authors discuss implications for social comparison theory and its applications in health care.

Diurnal cortisol rhythm and fatigue in breast cancer survivors.

Approximately 30% of breast cancer survivors report persistent fatigue of unknown origin. We have previously shown that cancer-related fatigue is associated with alterations in immunological parameters and serum cortisol levels in breast cancer survivors. The current study examined the diurnal rhythm of salivary cortisol in fatigued and non-fatigued breast cancer survivors. Salivary cortisol measures were obtained from breast cancer survivors with persistent fatigue (n=13) and a control group of non-fatigued survivors (n=16). Participants collected saliva samples upon awakening and at 1200, 1700, and 2200 h on two consecutive days. Diurnal cortisol slope for each day was determined by linear regression of log-transformed cortisol values on collection time and analyzed using multi-level modeling. Fatigued breast cancer survivors had a significantly flatter cortisol slope than non-fatigued survivors, with a less rapid decline in cortisol levels in the evening hours. At the individual patient level, survivors who reported the highest levels of fatigue also had the flattest cortisol slopes. Group differences remained significant in analyses controlling for demographic and medical factors, daily health behaviors, and other potential confounds (e.g. depressed mood, body mass index). Results suggest a subtle dysregulation in hypothalamic-pituitary-adrenal axis functioning in breast cancer survivors with persistent fatigue.

Negative social evaluation, but not mere social presence, elicits cortisol responses to a laboratory stressor task.

BACKGROUND Recent research has supported the premise that performance conditions characterized by social-evaluative threat, in which an aspect of the self could be judged by others, are associated with cortisol responses. However, it remains unclear whether this effect is due to negative social evaluation per se or simply the presence of another during a performance situation. METHOD In the present study, 89 undergraduates delivered a speech in 1 of 3 conditions: in front of an evaluative audience panel (social-evaluative threat [SET]), in the presence of an inattentive confederate (PRES), or alone in a room (non-SET). RESULTS Consistent with hypotheses, participants in the SET condition demonstrated a significant cortisol response, while those in the non-SET and PRES conditions did not show increases in this hormone. Further, participants in the SET condition who reported greater posttask levels of self-conscious cognitions and emotions demonstrated the greatest increases in cortisol. CONCLUSION These findings suggest that the mere social presence of others is not driving the changes in cortisol observed under social-evaluative threat; instead, explicit negative social evaluation may be responsible for increases in this health-relevant physiological parameter.

Emotion regulation and cortisol reactivity to a social-evaluative speech task.

BACKGROUND Previous laboratory studies have found a relationship between experimentally manipulated emotion regulation strategies such as suppression and reappraisal and cardiovascular reactivity. However, these studies have not examined trait forms of these strategies and cortisol responses. The aim of the present study is to investigate the relationship between trait suppression, reappraisal, and cortisol reactivity to a social-evaluative speech task. METHODS Participants completed the Emotion Regulation Questionnaire [ERQ; Gross, J.J., John, O.P., 2003. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J. Pers. Soc. Psychol. 85, 348-362] to assess trait suppression and reappraisal and were asked to complete a speech task in front of an evaluative audience. They provided five saliva samples throughout the duration of the session to assess cortisol response patterns. RESULTS Consistent with hypotheses, trait suppression predicted exaggerated cortisol responses to the speech task, with those scoring higher on suppression exhibiting greater cortisol reactivity. High levels of trait reappraisal also predicted exaggerated cortisol reactivity to the speech task. CONCLUSIONS Findings suggest that certain emotion regulation strategies such as suppression and reappraisal predict heightened cortisol reactivity to an acute stressor. Future studies should examine the psychological mechanisms through which these emotion regulation strategies affect cortisol response patterns.

Rumination and cortisol responses to laboratory stressors.

Objective: For some, a stressor’s psychological and physiological influence ceases on removal; for others, the effects may persist through rumination. These repetitive, intrusive thoughts might prolong physiological stress responses. Previous studies produced mixed results, indicating a need to clarify the relationship between rumination and cortisol responses. The current study investigated whether a laboratory speech task is sufficient to elicit rumination and whether those who ruminated in response to the speech task have elevated cortis of responses. Additionally, whether trait depressive rumination follows a similar pattern was examined. It was hypothesized that those delivering speeches in a social-evaluative context would experience more posttask rumination and that greater posttask rumination would predict elevated cortisol responses. Methods: Eighty-nine participants performed a speech in front of an evaluative panel (SET) or in one of two nonexplicitly evaluative conditions. Participants indicated the frequency of the thoughts they experienced during a 10-minute rest period after the speech as a measure of posttask rumination. Salivary cortisol was collected at five time points throughout the session. Results: The SET condition elicited more posttask rumination than the nonexplicitly evaluative conditions. Posttask rumination was associated with amplified and prolonged elevations in cortisol across all conditions. Trait depressive rumination was associated with blunted cortisol responses in the SET condition. There was no association between trait depressive rumination and cortisol responses in the nonexplicitly evaluative conditions. Conclusion: Results suggest that the nature of the relationship between cortisol activation and rumination may be contingent on how rumination is conceptualized and measured. HPA = hypothalamic-pituitary-adrenocortical; SET = social-evaluative threat; neSET = nonexplicitly evaluative; RSQ-22 = 22-item Rumination Subscale of the Responses Style Questionnaire; TQ = Thoughts Questionnaire; ELISA = enzyme-linked immunosorbent assay.

Rumination predicts longer sleep onset latency after an acute psychosocial stressor.

Objectives: Rumination has been linked to self-reported sleep quality. However, whether rumination is related to an objective sleep parameter has not been tested. This study examined whether rumination predicts sleep onset latency (SOL) on the night after an acute psychosocial stressor. We hypothesized that those who ruminate (assessed with both trait and stressor-specific measures) would have longer SOL (assessed with objective and subjective methods). Methods: Seventy participants delivered a 5-minute speech in front of an evaluative panel during an afternoon laboratory session. Trait rumination was assessed before the stressor. Stressor-specific rumination was captured with the frequency of task-related thoughts participants experienced during a 10-minute rest period after the stressor. Participants wore actigraphs on their wrists on the night after the laboratory session to measure objective sleep onset latency (SOL-O). Subjective sleep onset latency was estimated by participants on the subsequent morning. Results: Consistent with hypotheses, trait and stressor-specific rumination predicted longer SOL-O and subjective sleep onset latency, respectively. In addition, trait and stressor-specific rumination interacted to predict longer SOL-O. SOL-O was longest among those who engaged in more stressor-specific rumination and had greater trait rumination scores. Neither rumination measure was related to sleep duration or wakefulness after sleep onset. Conclusions: The findings from this study are consistent with previous research linking rumination to subjective sleep quality. The results also suggest that post-stressor ruminative thought may predict delayed sleep onset for those with a propensity for rumination. SOL = sleep onset latency; SOL-O = objective sleep onset latency; SOL-S = subjective sleep onset latency; WASO = wakefulness after sleep onset..

Uncoupling of social zeitgebers and diurnal cortisol secretion in clinical depression.

Daily activities (zeitgebers) such as waking, eating, and exercising, done alone or in the presence of others, may help to entrain biological rhythms. To examine whether the relationship between zeitgebers and biological rhythms is altered in depression, this study tracked daily activity and cortisol secretion in 50 depressed and 50 control participants using a daily diary methodology. The groups reported similar levels of regular daily activities. Among control participants, regular daily activities were associated with a normative decline in cortisol secretion. Among depressed participants, daily activities and cortisol secretion were unrelated, consistent with the hypothesis that these activities are less able to entrain diurnal rhythms. This lack of social entrainment may underlie some of the circadian disturbances in depression.

Assessing the relationship between rumination and cortisol: A review

OBJECTIVE AND METHODS For individuals who ruminate, or mentally rehearse past stressful events, the physiological effects of a stressor may be longer lasting. This is well-supported within the cardiovascular domain. In the context of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol, the results are inconsistent. This review summarizes key theoretical and methodological issues that contribute to these mixed findings among the 15 studies to date that have examined the association between rumination and cortisol. RESULTS State measures of rumination were consistently linked to increased cortisol concentrations. Stress-related rumination questionnaires were often positively associated with cortisol, whereas depression-related rumination scales predicted lower cortisol concentrations or were unrelated to cortisol. Rumination manipulations in the laboratory (e.g., ruminative self-focused writing tasks compared to distraction writing tasks) influenced cortisol concentrations, but often did not increase cortisol relative to baseline values. Studies that utilized social-evaluative stressor tasks to examine the relationship between rumination and cortisol levels generally showed that rumination predicted greater cortisol reactivity or delayed recovery. Results from studies examining rumination and basal cortisol or the cortisol awakening response were inconsistent. CONCLUSION The ways in which researchers conceptualize and assess rumination and the associated cortisol response influences the association between rumination and cortisol. Suggestions for future studies in this area of research are provided.

Psychobiological Responses to Social Self Threat: Functional or Detrimental?

A growing body of research suggests that threats to the social self, or threats to ones social esteem, acceptance, or status, can elicit a coordinated response, including increases in self-conscious emotion, cortisol, and proinflammatory cytokine activity. These psychobiological changes may have important benefits under certain acute contexts, including providing a signaling function for detecting social threat, initiating biological processes to adequately respond to the threat, and supporting behavioral patterns of submission or disengagement, which may be adaptive in this context. However, prolonged or chronic experiences of social self threat could have damaging mental and physical health consequences; situational and individual characteristics may render some more vulnerable to these negative effects.